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Volume 12, Number 2—February 2006

Research

Rickettsial Infections and Fever, Vientiane, Laos

Simaly Phongmany*, Jean-Marc Rolain†, Rattanaphone Phetsouvanh*, Stuart D. Blacksell*‡§, Vimone Soukkhaseum*, Bouachanh Rasachack*, Khamphong Phiasakha*, Surn Soukkhaseum*, Khamthavi Frichithavong*, Vang Chu*, Valy Keolouangkhot*¶, Bertrand Martinez-Aussel*#, Ko Chang*, Chirapha Darasavath*, Oudayvone Rattanavong*, Siho Sisouphone*, Mayfong Mayxay*#, Sisouphane Vidamaly*¶, Philippe Parola†, Chanpheng Thammavong*, Mayboun Heuangvongsy*, Bounkong Syhavong*, Didier Raoult†, Nicholas J. White*‡§, and Paul N. Newton*‡Comments to Author 
Author affiliations: *Mahosot Hospital, Vientiane, Laos; †Université de la Méditerranée, Marseille, France; ‡University of Oxford, Oxford, United Kingdom; §Mahidol University, Bangkok, Thailand; #National University of Laos, Vientiane, Laos; ¶Francophone Institute for Tropical Medicine, Vientiane, Laos

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Table 1

Admission clinical features of 104 Lao adults with serologic evidence of acute murine and scrub typhus*

Variable Murine typhus (n = 41)† Scrub typhus (n = 63)† p value Reference range
Age, (y)‡ 40 (17–70) 31 (16–73) 0.5
No. (%) male 26 (63) 40 (63) 0.6
No. days ill‡ 11 (3–30) 10 (2–42) 0.2
Headache (%) 38 (95) (n = 40) 60 (95) 1.0
Abdominal pain (%) 17 (43) (n = 40) 22 (35) 0.5
Nausea (%) 18 (45) (n = 40) 39 (62) 0.09
Vomiting (%) 11 (28) (n = 40) 25 (40) 0.3
Diarrhea (%) 7 (18) (n = 40) 22 (35) 0.07
Cough (%) 14 (35) (n = 40) 24 (38) 0.8
Sputum (%) 8 (20) (n = 40) 13 (21) 1.0
Dyspnea (%) 5 (13) (n = 40) 7 (11) 1.0
Chest pain (%) 3 (8) (n = 40) 13 (21) 0.1
Back pain (%) 15 (38) (n = 40) 19 (30) 0.5
Dysuria (%) 3 (8) (n = 40) 2 (3) 0.4
Arthralgia (%) 10 (25) (n = 40) 13 (21) (n = 62) 0.6
Myalgia (%) 34 (85) (n = 40) 59 (95) (n = 62) 0.1
Sore throat (%) 3 (8) (n = 40) 12 (19) 0.2
Lymphadenopathy (%) 1 (3) (n = 38) 27 (46) (n = 59) <0.001
Bleeding (%) 2 (5) (n = 39) 4 (6) (n = 58) 1.0
Convulsions (%) 0 (n = 40) 1 (2) (n = 62) 1.0
Rash (%) 5 (13) (n = 38) 16 (27) (n = 59) 0.1
Abnormal chest exam (%) 1 (3) (n = 38) 16 (27) (n = 59) 0.002
Abdominal tenderness (%) 1 (3) (n = 39) 6 (10) (n = 59) 0.2
Liver palpable (%) 27 (73) (n = 37) 30 (52) (n = 58) 0.05
Spleen palpable (%) 6 (15) (n = 39) 9 (15) (n = 59) 1.0
Temperature (°C)‡ 38.5 (38.2–38.8) (n = 36) 38.6 (38.4–38.9) (n = 56) 0.3
Pulse/min§ 91.1 (87.1–95.1) (n = 36) 95.7 (91.8–99.6) (n = 54) 0.09
Systolic blood pressure (mm Hg)‡ 100 (80–130) (n = 36) 100 (90–150) (n = 54) 0.6
Diastolic blood pressure (mm Hg)‡ 70 (50–80) (n = 36) 65 (50–110) (n = 54) 0.8
Respiratory rate/min§ 20.7 (19.9–21.6) (n = 36) 22.9 (22.0–23.8) (n = 58) 0.0012
Glasgow Coma Score‡ 15 (15) (n = 38) 15 (7–15) (n = 59) 0.3
Meningism (%) 2 (5) (n = 39) 7 (12) (n = 59) 0.3
Hematocrit (%)‡ 40 (13–48) (n = 35) 40 (23–50) (n = 53) 0.7
Leukocyte count (×109/L)‡ 10.4 (3.1–38) (n = 37) 11.8 (0.7–26.3) (n = 54) 0.1 4.0–11.0
Neutrophils (%)‡ 68 (26-86) (n = 37) 70 (0–93) (n = 54) 0.2
Platelets (×109/L)§ 190 (23–350) (n = 37) 200 (192–208) (n = 49) 0.4 150–400
Serum creatinine (μmol/L)‡ 106 (70–466) (n = 32) 106 (70–783) (n = 53) 0.7 53–123
Serum AST (IU/L)‡ 87 (32–789) (n = 31) 86 (16–437) (n = 52) 0.6 7–35
Serum ALT (IU/L)‡ 39 (20–234) (n = 31) 48 (12–180) (n = 52) 0.7 7–35
Serum albumin (g/L)‡ 38 (26–50) (n = 32) 35 (22–49) (n = 53) 0.2 35–50
Serum creatinine kinase (IU/L)¶ 113 (80–159) (n = 32) 121 (70–210) (n = 53) 0.8 24–190
Serum alkaline phosphatase (IU/L)‡ 156 (47–532) (n = 32) 175 (55–745) (n = 53) 0.5 120–290
Serum direct bilirubin (μmol/L)‡ 8.3 (1.7–60.4) (n = 32) 8.3 (2.6–83.0) (n = 52) 0.9 0.5–8.8
Serum total bilirubin (μmol/L)‡ 17.9 (7.7–109) (n = 32) 18.4 (7.7–131) (n = 52) 0.4 1.7–20
No. patients serum total bilirubin >50 μmol/L (%) 2 (6) (n = 32) 4 (8) (n = 52) 1.0
No. patients serum AST >105 IU/L (%) 11 (36) (n = 31) 18 (35) (n = 52) 1.0
No. patients serum ALT >105 IU/L (%) 6 (19) (n = 31) 5 (10) (n = 52) 0.3
Deaths (%) 0 1 (1.5)

*AST, aspartate aminotransferase; ALT, alanine aminotransferase; CI, confidence interval.
†The available sample size is given in parentheses where the entire sample was not available for a given variable.
‡Median (range).
§Mean (95% CI).
¶Geometric mean (95% CI).

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